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2003 Abstracts
387
EFFECTS OF TRIMETAZIDINE ON TARGET ORGAN DAMAGE IN HYPERTENSIVE DIABETIC PATIENTS
KR Sahakyan, RP Sahakyan, SK Vatinyan, DN Aslanyan, ES Mikaelyan, MF Drampyan
Yerevan, Armenia
The effect of trimetazidine on cardiac and renal function is not clearly determined in patients with hypertension and diabetes. The aim of this study was to determine the influence of trimetazidine on left ventricular (LV) diastolic function and renal disease progression.
METHODS: 74 hypertensive patients (mean age 50.9 ± 6.5 years) were studied to assess effect of trimetazidine (70 mg/day) for 4 and 24 weeks in addition to hypoglycaemic and/or antihypertensive therapy. The patients were divided in two groups as 40 nondiabetic (group I) and 34 diabetic patients (group II). Early filling velocity (E), late filling velocity (A), E/A ratio were obtained by Doppler echocardiography. A decline in kidney function was defined as an increase in serum creatinine
(
RESULTS: The groups were matched for age, sex, BP level, duration of hypertension. After 4 weeks of observation normalization of E/A was registered in
17.5 %, 8.9 % and 6.7% patients in I, II and III groups, respectively. After the end of follow up normal diastolic filling was detected more often in groups I and II (47.5% and 29.4%, respectively), while only in 10.0 % patients in group III (p<0.01 vs groups I and II). After 24 weeks of therapy trimetazidine produced significant reduction of serum creatinine level and increase of creatinine clearance only in group II (168.8 ±22.2 vs 284.6 ± 26.6 mgr/mmol/l, p <0.01 and 72.2 ± 8.0 vs 50.5 ± 6.2 ml/min, p <0.05, respectively,). In patients in group I serum creatinine and creatinine clearance changed positively, but non-significantly (186.0 ±12.2 vs 220.6 ± 12.6 mgr/mmol/l and 70.2 ± 12.0 vs 60.5 ± 10.2 ml/min, respectively, p = NS for both). No correlation was found between these changes and BP and glucose levels. In patients in group III there was not detected improvement of renal function, moreover creatinine clearance slightly reduced in these patients (46.5 ± 5.4 vs 54.5 ± 6.4 ml/min, P=NS).
CONCLUSION: Our data established that trimetazidine attenuated LV diastolic dysfunction in hypertensive nondiabetic patients mostly. Twenty-four weeks treatment is enough time for the reduction of the rate of renal disease progression in hypertensive patients with concomitant diabetes mellitus.
DNC